ABSTRACT
Radiotherapy has proved an effective modality for cancer treatment with more than 50% of all cancer patients undergoing some form of radiation treatment. It has been reported as curative in several malignancies including, Hodgkin’s lymphoma, seminoma, basal cell, and squamous carcinomas of the head and neck (1). Radiotherapy has demonstrated efficacy in reducing local recurrence and producing downstaging as adjuvant therapy and has been used as palliation for unresectable malignancies. Radiation-induced skin and subcutaneous tissue damage is the most common side effect of radiotherapy with up to 95% of the patients experiencing some degree of reaction (2–4). As the efficacy and application of radiotherapy has increased and the life expectancy of cancer patients has risen, there has been a corresponding rise in the number of patients suffering from radiation-induced injury despite improvements in radiation techniques. Ionizing radiation produces functional and morphological changes in noncancerous tissue. These complications can range from mild skin reactions to nonhealing ulcers that are susceptible to life-threatening infections (5). Energy transference from ionizing radiation generates highly reactive chemical products with a burst of free radicals that react with proteins, lipids, and carbohydrates to ultimately cause damage to cellular and nuclear membranes and deoxyribonucleic acid (DNA). Morbidity of radiation is dependent on the individual cell sensitivity, rate dose accumulation, volume of tissue irradiated, quality or type of radiation, chemotherapy, and surgical trauma (6).
